Bismuth-Corlette Bismuth-Corlette classification of hilar cholangiocarcinoma

vigente

Classifies hilar cholangiocarcinoma by extent of biliary involvement.

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Escala de categorias

I II IIIa IIIb IV

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Procedência e vigência

Órgão emissor: Surgical consensus
Versão: 1975
Ano: 1975
Família: léxico
Tipo de lógica: flat
Modalidade: MRI, CT
Fonte primária: Intrahepatic cholangioenteric anastomosis in carcinoma of the hilus of the liver (Bismuth-Corlette)
Última verificação: 2026-06-22
Última checagem: 2026-06-22

Lógica de decisão

Forma estruturada (flat). Uma futura calculadora a lê; as categorias abaixo são a superfície legível.

Mostrar a lógica estruturada (JSON)

{
  "categories": [
    "I",
    "II",
    "IIIa",
    "IIIb",
    "IV"
  ]
}

Categorias num relance

Cat.	Significado	Conduta	Risco	Fonte
I	Type I Tumor confined to the common hepatic duct, distal (below) the confluence of the right and left hepatic ducts; the biliary confluence is not involved.	Resectable type I (with type II) is treated by right hepatectomy; ERCP is the preferred primary preoperative biliary drainage route for Bismuth-Corlette I and II.	—	okfonte Criteria: NBK560708 (StatPearls Cholangiocarcinoma), Bismuth-Corlette description: type I = 'Tumors distal to the confluence of the left and right hepatic ducts'. Management (retained): PMC10989497, 'SURGICAL RESECTION' and 'ROLE OF PREOPERATIVE BILIARY DRAINAGE' sections.
II	Type II Tumor reaches and involves the hepatic duct confluence (the junction of the right and left hepatic ducts) but does not extend into the proximal right or left hepatic ducts.	Resectable type II (with type I) is treated by right hepatectomy; ERCP is the preferred primary preoperative biliary drainage route for Bismuth-Corlette I and II.	—	okfonte Criteria: NBK560708 (StatPearls Cholangiocarcinoma): type II = 'Tumors involving the hepatic duct confluence'. Management (retained): PMC10989497, 'SURGICAL RESECTION' and biliary-drainage recommendation.
IIIa	Type IIIa Tumor involves the confluence and extends into the proximal RIGHT hepatic duct (obstructing the common hepatic duct plus the proximal right hepatic duct).	Generally requires right trisectionectomy (extent of resection in type III is dictated by biliary extent, lobar atrophy, vascular involvement, side of biliary dominance, and hilar anatomical variations); for preoperative biliary drainage, combined ERCP plus PTBD or PTBD alone is recommended for Bismuth-Corlette III, and PTBD may be considered for initial drainage in IIIa.	—	okfonte Criteria: NBK560708 (StatPearls Cholangiocarcinoma): type IIIa = 'Tumors obstructing the common hepatic duct and the proximal right hepatic duct'. Management (retained): PMC10989497, 'SURGICAL RESECTION' and biliary-drainage text.
IIIb	Type IIIb Tumor involves the confluence and extends into the proximal LEFT hepatic duct (obstructing the common hepatic duct plus the proximal left hepatic duct).	Generally requires left trisectionectomy (extent of resection in type III is dictated by biliary extent, lobar atrophy, vascular involvement, side of biliary dominance, and hilar anatomical variations); for preoperative biliary drainage, combined ERCP plus PTBD or PTBD alone is recommended for Bismuth-Corlette III.	—	okfonte Criteria: NBK560708 (StatPearls Cholangiocarcinoma): type IIIb = 'Tumors obstructing the common hepatic duct and the proximal left hepatic duct'. Management (retained): PMC10989497, 'SURGICAL RESECTION' and biliary-drainage recommendation.
IV	Type IV Multicentric tumor, OR tumor involving the confluence and extending into BOTH the proximal right and left hepatic ducts (bilateral, up to the secondary/segmental radicles).	Selected resectable cases are treated by right trisectionectomy (with types IIIa) or left trisectionectomy (with types IIIb), the choice dictated by biliary extent, lobar atrophy, vascular involvement, side of biliary dominance, and hilar anatomy; combined ERCP plus PTBD or PTBD alone is the recommended preoperative biliary drainage approach for type IV.	—	okfonte Criteria: NBK560708 (StatPearls Cholangiocarcinoma): type IV = 'Tumors that are multicentric or involve the confluence and both the right or left hepatic duct'. Management (retained): PMC10989497, 'SURGICAL RESECTION' and biliary-drainage recommendation.

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